Drug interactions
Captopril-hydrochlorothiazide + Sacubitril / valsartan
Severity: Contraindicated
Captopril-hydrochlorothiazide and Sacubitril / valsartan: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Neprilysin inhibition by sacubitril together with ACE inhibition impairs bradykinin breakdown and substantially raises the risk of angioedema, which can be life-threatening. Additional valsartan effects add to hypotension, hyperkalemia and renal risks.
What this interaction means in plain words
Captopril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Concurrent inhibition of neprilysin and ACE reduces bradykinin degradation, causing excess bradykinin-mediated angioedema.
What to do
Never give together; allow at least 36 hours between the last ACE inhibitor dose and the first sacubitril/valsartan dose, and vice versa.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Captopril-hydrochlorothiazide
- Aliskiren + Captopril-hydrochlorothiazide Contraindicated
- Captopril-hydrochlorothiazide + Dofetilide Contraindicated
- Aceclofenac + Captopril-hydrochlorothiazide Major
- Aldesleukin + Captopril-hydrochlorothiazide Major
- Amifostine + Captopril-hydrochlorothiazide Major
- Amiloride + Captopril-hydrochlorothiazide Major
Frequently asked questions
Can I take Captopril-hydrochlorothiazide with Sacubitril / valsartan?
MediHelp rates the interaction as contraindicated. Captopril-hydrochlorothiazide and Sacubitril / valsartan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Neprilysin inhibition by sacubitril together with ACE inhibition impairs bradykinin breakdown and substantially raises the risk of angioedema, which can be life-threatening. Additional valsartan effects add to hypotension, hyperkalemia and renal risks.
How serious is the interaction between Captopril-hydrochlorothiazide and Sacubitril / valsartan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Never give together; allow at least 36 hours between the last ACE inhibitor dose and the first sacubitril/valsartan dose, and vice versa.
What other medicines interact with Captopril-hydrochlorothiazide?
MediHelp also lists interactions of Captopril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Aceclofenac. The full list is on the Captopril-hydrochlorothiazide page.
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